Welcome to PT 635 Pathophysiology of Complex Patient Problems This is a wiki created by and for the students in the School of Physical Therapy at Bellarmine University in Louisville KY. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!

Definition/Description[edit | edit source]

  • Cervicitis is defined as the inflammatory response of the cervix to a particular stimuli[1]
  • Can be acute or chronic; with chronic occurring due to inadequate treatment or recurrent inflammation[1]
  • Non-specific cervicitis is the most common; meaning that it is unrelated to an STI like chlamydia or gonorrhea [2]
  • A single instance or acute cervicitis is usually due to an infection like chlamydia or gonorrhea, while chronic is typically due to a non-infectious source[3]
  • If left untreated cervicitis can lead to pelvic inflammatory disease[2]
GC 3.jpg

Prevalence[edit | edit source]

Cervicitis is currently rarely reported to epidemiologists making true numbers for prevalence roughly estimated from about 8%-40% [1]

  • About 61% of cervicitis cases are of unknown etiology [4]

Characteristics/Clinical Presentation[edit | edit source]

In many case cervicitis remains asymptomatic

  • If symptomatic, person may experience vaginal discharge, dyspareunia, intermenstrual bleeding, or postcoital bleeding [1]
  • Occasionally will present in an abnormal fashion, such as a cervical growth or uterovaginal prolapse, but that is rare and usually due to delayed or no treatment [1]
    GC 2 .jpg

Associated Co-morbidities[edit | edit source]

In many cases, Mycoplasma Genitalium bacteria occurs simultaneously with cervicitis [4]

  • Gonorrhea and chlamydia is also commonly found in correlation with cervicitis [4][5]

Medications[edit | edit source]

Antibiotics are frequently given once cervicitis is found

  • No other medications are usually prescribed to help with this condition[6]

Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]

In order to diagnose a culture is taken to look for mucopurulent discharge [7]

  • A culture is taken to look for specific bacteria like chlamydia, gonorrhea, or mycoplasma genitalium [7]

Etiology/Causes[edit | edit source]

  • Cervicitis can be associated with preterm childbirth and pelvic inflammatory disease[7]
  • Chlamydia, gonorrhea, trichomonas, bacterial vaginosis and mycoplasma genitalium are all seen to contribute to acute, infectious cervicitis [7]
  • Decreased use of condoms with sexual activity are shown to increase the risk for acquiring cervicitis [2]
  • Lower education and multiple sexual partners were also seen to contribute to the condition [2]
  • Cytomegalovirus has recently been shown to lead to cervicitis as well [8]

  • GC 1.jpg

Systemic Involvement[edit | edit source]

Untreated, cervicitis can lead to pelvic inflammatory disease (PID) [5]

  • Postcoital bleeding is also a common occurrence when cervicitis in inadequately or not treated[9]

Medical Management (current best evidence)[edit | edit source]

Best evidence, is currently antibiotic therapies [4]

  • Complementary and Alternative Medicine is now being introduced to treat this diagnosis [6]

Physical Therapy Management (current best evidence)[edit | edit source]

The evidence for PT management of Cerivicitis is low level. Theoretical options have been proposed to include the following but research has not substanitated their use:

  • Electrotherapy [6]
  • Magnet therapy[6]
  • Heat therapy[6]
  • Light therapy[6]
  • External high frequency calorimetry[6]
  • Low frequency pulsed ultrasound therapy [6]
  • Iontophoresis[6]
  • Shortwave ultrasound combined with intermediate frequency electrical stimulation[6]
  • Ozone therapy[6]
  • Shortwave diathermy[10]

Differential Diagnosis[edit | edit source]

  • Cystic cervicitis[11]
  • Vaginosis[4]
  • Vulva vaginitis[8]
  • Herpes Simplex Virus[8]

Case Reports/ Case Studies[edit | edit source]

Case study of a 55 year old female with an ongoing case of untreated cervicitis which produced a growth that mimicked a cervical tumor online.liebertpub.com/doi/abs/10.1089/gyn.2014.0070

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References[edit | edit source]

  1. 1.0 1.1 1.2 1.3 1.4 Singh N, Arora A. An Extreme Case of Chronic Cervicitis Mimicking Cervical Cancer and Causing Third-Degree Prolapse. Journal Of Gynecologic Surgery [serial online]. December 2014;30(6):380-382. Available from: Academic Search Complete, Ipswich, MA. Accessed February 23, 2017.
  2. 2.0 2.1 2.2 2.3 Pollett S, Calderon M, Heitzinger K, Solari V, Montano S, Zunt J. Prevalence and predictors of cervicitis in female sex workers in Peru: an observational study. BMC Infectious Diseases [serial online]. April 30, 2013;13:195. Available from: MEDLINE, Ipswich, MA. Accessed February 23, 2017.
  3. Efosa O, Uwadiegwu A. Cytopathological Examination and Epidemiological Study of Cervicitis in Commercial Sex Workers (Csws) in Coal City (Enugu), Nigeria. Ethiopian Journal Of Health Sciences [serial online]. July 2015;25(3):225-230. Available from: Academic Search Complete, Ipswich, MA. Accessed April 4, 2017.
  4. 4.0 4.1 4.2 4.3 4.4 Taylor S, Lensing S, Lee J, et al. Prevalence and treatment outcome of cervicitis of unknown etiology. Sexually Transmitted Diseases [serial online]. May 2013;40(5):379-385. Available from: CINAHL with Full Text, Ipswich, MA. Accessed February 23, 2017.
  5. 5.0 5.1 Sheeder J, Stevens-Simon C, Lezotte D, Glazner J, Scott S. Cervicitis: To Treat or Not To Treat? The Role of Patient Preferences and Decision Analysis. Journal Of Adolescent Health [serial online]. December 2006;39(6):887-892. Available from: PsycINFO, Ipswich, MA. Accessed March 22, 2017
  6. 6.00 6.01 6.02 6.03 6.04 6.05 6.06 6.07 6.08 6.09 6.10 Liu C, Zhang Y, Kong S, Tsui I, Yu Y, Han F. Applications and therapeutic actions of complementary and alternative medicine for women with genital infection. Evidence-Based Complementary And Alternative Medicine: Ecam [serial online]. 2014;2014:658624. Available from: MEDLINE, Ipswich, MA. Accessed April 4, 2017.
  7. 7.0 7.1 7.2 7.3 Lusk M, Garden F, Rawlinson W, Naing Z, Cumming R, Konecny P. Cervicitis aetiology and case definition: a study in Australian women attending sexually transmitted infection clinics. Sexually Transmitted Infections [serial online]. May 2016;92(3):175-181. Available from: MEDLINE, Ipswich, MA. Accessed February 23, 2017.
  8. 8.0 8.1 8.2 Abou M, Dällenbach P. Acute cervicitis and vulvovaginitis may be associated with Cytomegalovirus. BMJ Case Reports [serial online]. April 19, 2013;2013 Available from: MEDLINE, Ipswich, MA. Accessed March 22, 2017.
  9. Liu H, Chen C, Pai L, Hwu Y, Lee H, Chung Y. Comorbidity profiles among women with postcoital bleeding: a nationwide health insurance database. Archives Of Gynecology & Obstetrics [serial online]. April 2017;295(4):935-941. Available from: Academic Search Complete, Ipswich, MA. Accessed March 22, 2017.
  10. Lamina S, Hanif S, Gagarawa Y. Short wave diathermy in the symptomatic management of chronic pelvic inflammatory disease pain: a randomized controlled trial. Physiotherapy Research International [serial online]. March 2011;16(1):50-56. Available from: CINAHL with Full Text, Ipswich, MA. Accessed February 23, 2017.
  11. Oliveto J, Muinov L. Cystic Cervicitis: A Case Report and Literature Review of Cystic Cervical Lesions. Journal Of Computer Assisted Tomography [serial online]. July 2016;40(4):564-566. Available from: MEDLINE, Ipswich, MA. Accessed February 23, 2017.